2015 Club Membership Application
US Complete Shooting Dog Assoc.

Name of Club: ____________________________________________

State in Which Field Trials will be Held:  _____________________

President: ________________________________________________

Address: _________________________________________________

City, State, & Zip: _________________________________________

Secretary: ________________________________________________

Address: _________________________________________________

Contact & were to send Club notifications:

Name: _____________________________     Title:  ______________

Email: ___________________________     Phone: _______________

Mailing address if different from above: __________________________________________________________

Please return this completed form to:
USCSDA National Secretary